Original articles
Risk factors for deliberate self-harm in young people in rural Sri Lanka: a prospective cohort study of 22,000 individuals
Authors:
Kiyara Fernando ,
Kings College Hospital, London, GB
Shaluka Jayamanna,
University of Peradeniya, LK
About Shaluka
Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC)
Faculty of Medicine, University of Kelaniya
Manjula Weerasinghe,
University of Peradeniya, LK
About Manjula
Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC)
Chamil Priyadarshana,
University of Peradeniya, LK
About Chamil
Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC)
Rohan Ratnayake,
Ministry of Health, LK
About Rohan
Directorate of Mental Health
Melissa Pearson,
University of Peradeniya, GB
About Melissa
Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC)
Centre for Pesticide Suicide Prevention, University of Edinburgh, UK
David Gunnell,
University of Peradeniya, GB
About David
Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC)
Bristol Medical School; Population Health Sciences, University of Bristol, UK
Andrew Dawson,
University of Peradeniya, AU
About Andrew
Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC)
Sydney Medical School, University of Sydney, Australia
Keith Hawton,
University of Oxford, GB
About Keith
Centre for Suicide Research, Department of Psychiatry
Flemming Konradsen,
University of Peradeniya, DK
About Flemming
Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC)
Centre for Pesticide Suicide Prevention, University of Edinburgh, UK
Michael Eddleston,
University of Peradeniya, LK
About Michael
Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC)
Centre for Pesticide Suicide Prevention, University of Edinburgh, UK
Chris Metcalfe,
University of Bristol, GB
About Chris
Bristol Medical School; Population Health Sciences
Duleeka Knipe
University of Peradeniya, GB
About Duleeka
Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration (SACTRC),
Abstract
Background: Over 90% of youth suicide deaths occur in low- and middle-income countries. Despite this relatively little is known about risk factors in this context.
Aims: Investigate risk factors for deliberate self-harm (non-fatal) in young people in rural Sri Lanka.
Methods: A prospective cohort study of 22,401 individuals aged 12-18 years with complete data on sex, student status, household asset score, household access to pesticides and household problematic alcohol use. Deliberate self-harm was measured prospectively by reviewing hospital records. Poisson regression estimated incidence rate ratios (IRRs) for the association of risk factors with deliberate self-harm.
Results: Females were at higher risk of deliberate self-harm compared to males (IRR 2.05; 95%CI 1.75 – 2.40). Lower asset scores (low compared to high: IRR 1.46, 95%CI 1.12 - 2.00) and having left education (IRR 1.61 95%CI 1.31 – 1.98) were associated with higher risks of deliberate self-harm, with evidence that the effect of not being in school was more pronounced in males (IRR 1.94; 95%CI 1.40 – 2.70) than females. There was no evidence of an association between household pesticide access and deliberate self-harm risk, but problematic household alcohol use was associated with increased risk (IRR 1.23; 95%CI 1.04 – 1.45), with evidence that this was more pronounced in females than males (IRR for females 1.42; 95%CI 1.17 – 1.72). There was no evidence of deliberate self-harm risk being higher at times of school exam stress.
Conclusion: Indicators of lower socioeconomic status, not being in school, and problematic alcohol use in households, were associated with increased deliberate self-harm risk in young people.
How to Cite:
Fernando, K., Jayamanna, S., Weerasinghe, M., Priyadarshana, C., Ratnayake, R., Pearson, M., Gunnell, D., Dawson, A., Hawton, K., Konradsen, F., Eddleston, M., Metcalfe, C. and Knipe, D., 2021. Risk factors for deliberate self-harm in young people in rural Sri Lanka: a prospective cohort study of 22,000 individuals. Ceylon Medical Journal, 66(2), pp.87–95. DOI: http://doi.org/10.4038/cmj.v66i2.9469
Published on
20 Dec 2021.
Peer Reviewed
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